Article

Clinicians commonly recommend that power wheelchair users with spinal
cord injury perform wheelchair tilt and recline maneuvers to redistribute seating
loads away from the ischial tuberosities. However, ischial pressure reduction may
be accompanied by coccygeal pressure increases. Although the coccyx is among the
most common sites of pressure ulcers, few studies have reported coccygeal
interface pressure. The purpose of this study was to investigate both ischial and
coccygeal interface pressures in response to changes in wheelchair tilt and
recline angles. DESIGN: Thirteen power wheelchair users were recruited into this
study. Six combinations of wheelchair tilt (15, 25, and 35 degrees) and recline
(10 and 30 degrees, corresponding to traditional recline conventions of 100 and
120 degrees, respectively) angles were tested in random order. Each combination
was tested with 5 mins of upright sitting, 5 mins of tilt and recline, as well as
5 mins of maximal pressure relief recovery. Peak pressure indices were calculated
at the ischial and coccygeal sites. RESULTS: Ischial pressures monotonically
decreased in response to increasing combinations of tilt and recline. Increments
of 15 degrees of tilt did not produce significant differences under either
recline angle, whereas increments of 25 degrees of tilt produced significant
differences under both recline angles. Coccygeal pressures increased in response
to the four smallest (of six) combinations of tilt and recline, whereas they
decreased in response to the largest two combinations. CONCLUSIONS: Ischial
pressures seemed to be redistributed to the coccyx in response to the four
smallest angle combinations and redistributed to the back support in response to
the two largest angle combinations. Future work should confirm this pressure
redistribution to the back support and determine the back support locations of
redistribution.

Langue : ANGLAIS